Ranke complex (tuberculosis)

Last revised by Daniel J Bell on 14 Jun 2020

Ranke complex is seen in 'healed' primary pulmonary tuberculosis and is a later manifestation of the Ghon complex. It consists of two components:

  • a Ghon lesion that has undergone calcification
  • an ipsilateral calcified mediastinal node

It is important to note that a Ranke complex is not specific (see below).

History and etymology

Karl Ernest Ranke (1870-1926) was a German physician who developed the (now outdated) hypothesis on the pathology of pulmonary tuberculosis, which became known as "Ranke's stages of tuberculosis" 2.

Differential diagnosis

It should be noted that the imaging findings are completely non-specific. Sequelae of other granulomatous infections, such as healed thoracic histoplasmosis, can have identical imaging findings 3.

More rarely, a calcified or ossified lung metastasis 4 with ipsilateral hilar lymphadenopathy (e.g. from metastatic mucinous adenocarcinoma, osteosarcoma, or epithelial ovarian neoplasms 5) could give a similar imaging appearance.

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Cases and figures

  • Case 1: Ranke complex
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  • Case 1: Ranke complex - HRCT
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  • Case 2
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  • Case 3
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